Regimen for uncomplicated gonococcal infections of the cervix, urethra, or rectum:
- Ceftriaxone 500 mg IM as a single dose for persons weighing <150 kg (300 lb).
- For persons weighing ≥150 kg (300 lb), 1 g of IM ceftriaxone should be administered.
- If chlamydial infection has not been excluded, providers should treat for chlamydia with doxycycline 100 mg orally twice daily for 7 days. During pregnancy, azithromycin 1 g as a single dose is recommended to treat chlamydia.
- A test-of-cure is not needed for people who receive a diagnosis of uncomplicated urogenital or rectal gonorrhea unless symptoms persist.
- Patients who have been treated for gonorrhea should be retested three months after treatment to ensure there is no reinfection.
Alternative regimens for uncomplicated gonococcal infections of the cervix, urethra, or rectum if ceftriaxone is not available:
- Gentamicin 240 mg IM as a single dose plus azithromycin 2 g orally as a single dose OR
- Cefixime 800 mg orally as a single dose. If treating with cefixime, and chlamydial infection has not been excluded, providers should treat for chlamydia with doxycycline 100 mg orally twice daily for 7 days. During pregnancy, azithromycin 1 g as a single dose is recommended to treat chlamydia.
Recommended regimen for uncomplicated gonococcal infections of the pharynx:
- Ceftriaxone 500 mg IM as a single dose for persons weighing <150 kg (300 lb).
- For persons weighing ≥150 kg (300 lb), 1 g of IM ceftriaxone should be administered.
- If chlamydia coinfection is identified when pharyngeal gonorrhea testing is performed, providers should treat for chlamydia with doxycycline 100 mg orally twice a day for 7 days. During pregnancy, azithromycin 1 g as a single dose is recommended to treat chlamydia.
- A test-of-cure is recommended in people with pharyngeal gonorrhea 7-14 days after the initial treatment, regardless of the regimen.
